Abstract
Dementia: The International Journal of Social Research and Practice
This book has been written as a practical guide to help people living with dementia, their family members and formal caregivers traverse the complex field of dementia care and technology. Conscious that this field is rapidly changing and having worked for several years, on the ENABLE project (a five country, EU funded cross-national project led by Norway, that introduced assistive technologies (ATs) into the homes of people living with dementia and evaluated their use), I was keen to learn more about how the field has advanced over the last 15 years. I was also keen to find out more about the range of different technologies currently available for people living with dementia and their caregivers, their use and usefulness, key ethical concerns and the extent to which technology can either promote or undermine personhood. This book has well and truly satisfied my curiosity and I would definitely recommend it as a ‘must read’ for anyone interested in the topic.
The book is divided into three parts. Part one is broad: it deals with generic topics such the diverse challenges different dementia subtypes pose, assessment protocols with a focus on user-needs analysis and the moral and ethical dilemmas in the design, use and uptake of technologies. A key take-home message emerging from these chapters is that technologies can target a wide range of diverse needs from risk and safety to support with everyday activities and from communication and reminiscence to psycho-social stimulation, well-being and quality of life. Another take-home message is that the person and that person’s unique needs should always be kept central in any decision-making about the use of technology and that ethical principles should be a key priority embedded into the very early stages of technology design.
Part two of the book advances to a discussion about technology in the everyday lives of people living with dementia. It commences with a useful chapter about the range of technologies now available for installation in private homes in the United Kingdom. Here, the reader is reminded of the policy context for dementia care in the United Kingdom, the mixed economy of technologies and the fact that telecare is by far the most common AT used today in the United Kingdom. The classification of AT from those used (i) by the person with dementia, such as remote controls, prompting devices and reminders; to those used (ii) with the person with dementia, such as phones, puzzles, games and so on; to those used (iii) on the person with dementia, such as passive systems including alarms and global positioning system monitors; is useful. A common and recurring challenge for many people coping with the symptoms of dementia is that of getting lost in familiar and unfamiliar places and I found this chapter, especially that part dealing with different solutions to wayfinding, especially thought-provoking and helpful. Here, the importance of user involvement is once again emphasised, and the reader is reminded that ‘design for all’ does not always work.
Chapter six focuses on leisure time activities and technology. In this chapter, a comprehensive overview is provided of the various ways in which mobile applications can be personalised and used for leisure time activity both on a one-to-one basis and in group format. Chapter seven (probably the one I enjoyed most) is written by four people living with dementia. It details their unique experiences using technologies and decision-making in selecting the most appropriate technologies for use. Some very useful practical examples are provided of the frustrations and difficulties the person experiencing symptoms of cognitive impairment often encounters, in situations that most of us take for granted. The need for good support, helpful instructions, reliability and safety are emphasised in the context of technology use.
The final section of the book (part three) advances to explore the topic of ‘technology ecosystems’ for dementia. Chapter eight provides helpful guidance on how best to find out what is available in the area of technology. Here, the reader is cautioned about the reliability and credibility of acquiring online information and the important role health service professionals such as occupational therapists can play in this area is highlighted. Once again, we are reminded that the person living with dementia must be at the heart of all decision-making when it comes to the use of technology. Some important and basic questions are raised in this chapter such as who is the technology targeting, what are the main daily challenges arising because of the dementia, what are the risks involved in using technology, what alternatives could be used instead of technology and who is the main beneficiary?
Chapter nine focuses on technology use in human service organisations. Here, it is emphasised that good design and the judicious use of technology should fit seamlessly into the individual’s everyday life and that staff in human service organisations should be supported in digital literacy that is embedded in value-based practice. The final chapter of the book focuses on future directions in technological innovations in dementia. A particular focus here is on how technology will in the future be used to make the world more inclusive and dementia-friendly thereby enabling people to live well with dementia. Topics such as artificial intelligence, data mining, and citizen science are well defined and explored.
The book is written for people living with dementia, their caregivers and organisations that support them. It is well-researched, well-structured, international in both its writing and readership and easy to read. Its key themes are very clearly spelt out and reiterated throughout the chapters. I thought the case studies worked very well as did the take-home points at the end of each chapter. For future editions, I would like to read more about the ethics of the use of surveillance technology in long-term residential care settings and some coverage of the timing of the use of technology vis-à-vis the trajectory of dementia and the recycling/redistribution of no longer in use, publicly funded technologies to those families currently in need. I heartily welcome this comprehensive and helpful account of how technology can help people living with dementia and all of those who support that person.